Elderly people often feel there is no reliable alternative to hospital, Health Secretary Jeremy Hunt said, as he called for improved care from GPs.

Mr Hunt said GP contract changes brought in by Labour in 2004 had "undermined the personal link between GPs and the people on their lists".

But Clare Gerada, chair of the Royal College of GPs, said the problem was "nothing to do with the contract".

"It's to do with the fact we are 10,000 GPs short," she said.

Labour accused the current government of leaving A&E on the brink of crisis.

We need a much better way for vulnerable old people to journey through the NHSMr Hunt

Labour's Shadow Health Secretary Andy Burnham, who will raise the issue as an urgent question in the House of Commons later today, said: "In Jeremy Hunt's first year in office, nearly 1 million people waited more than 4 hours in A&E.

"Ministers have left it too late and until they face up to the fundamental causes - the collapse of social care and front-line job losses - the NHS will continue to struggle.

"This is further proof you can't trust David Cameron with the NHS. We can't have another year in the NHS like the last one - he needs to urgently get a grip."

Writing in the Daily Telegraph, Mr Hunt, who will outline proposed changes to ease pressure on stretched emergency departments, said: "A&E staff [now] know some patients better than their own GPs."

He told the BBC the government had "plans for 2,000 more GPs" and he would be "looking to see if that's enough".

Mr Hunt said it had become "impossible" for GPs to oversee their patients' treatment throughout the health and social care system.

He added: "I think it will take about four years to undo the damage done by those changes in 2004 but at least if we can undo it for the most frail and vulnerable older people next year, that will be an important step in the right direction."

Image caption
Dr Clare Gerada said the NHS was struggling due to "massive cuts" in its budget

Responsible GPs

"We need a much better way for vulnerable old people to journey through the NHS," Mr Hunt wrote in the Telegraph.

"They need someone from the service to be keeping tabs on them and championing them through the system all the time - and making sure they're a name, not a number, whether or not they are in hospital.

"As a member of the public I would like that responsible person to be my GP - but of course they will need support from many others, including our dedicated district nurses."

He added: "Since the last government's misguided changes to the GP contract, it's become easier to go to A&E and harder to go and see a GP."

Dr Gerada said GPs worked very long days, and even at night they were "delivering more care than most of the NHS".

She said the system was still working, but added: "It's working less well now, I'm afraid, than since [before] the massive cuts that we've seen, and also the enormous top-down reorganisation that we've just had."

Speaking about the health secretary's comments, she said: "I'm sure Mr Hunt regrets saying that emergency doctors know their patients better than their GPs because there's blatantly no evidence for that."

But in response, Mr Hunt said it was true that some patients know A&E doctors better than their GP.